Diabetes is one of those diseases that are detected only after harm has been done to the body. Unless symptoms become evident and, at times obvious to be seen from a distance, a patient does not take note of it.
During the unchecked period the disease continues to harm the entire body system of the patients and preparing them to face it as a painful disclosure of irreparable damage. What remains to deal with is usually termed by the doctors as diabetes management. It is through exercises and controlled dietary programme followed by regular intake of costly medicines and even costlier routine monitoring of blood sugar level.
Dr Fatima Jawad, a leading researcher in diabetes, in one of her articles published in the July 2003 issue of Diabetes Voice (Volume 48) has estimated that 12 percent people above 25 years of age suffer from the condition and 10 percent have impaired glucose tolerance (IGT) in Pakistan. In addition to this situation 43 percent diabetics are found suffering from eye complications, 20 percent from kidney problems and 40 percent from nerves problems. The problem continues to increase in Pakistan.
To increase the awareness level of this silent killer different organisations have been organising discussion programmes to tell people to take care of their diabetes and remain informed about its various dimensions.
Recently Professor Paul J. Thornalley and Dr Naila Ahmed Rabbani, both physicians and researchers, were in Karachi on a professional visit. They delivered lectures and participated a discussion programme to talk about 'B-Vitamins and Diabetes'.
Dr Paul is professor at Warwick University, heading Protein Damage and System Biology Research Group and Clinical Science Research Institute in the United Kingdom. He was associated with University of Essex UK as professor in disease mechanism and therapeutics in Department of Biology Sciences. He was a lecturer in Toxicology in the mechanisms of drug toxicity group in Aston University Birmingham, UK.
Dr Rabbani is a co-worker of Dr Paul at the University of Warwick, United Kingdom. She is also a research fellow in British Heart Foundation.
Dr Paul focussed his discussion on the role of Thiamine (Vitamin B-1) nutritional aspect and Thiamine deficiency in diabetes and how high doze Thiamine can prevent complications like dyslipidemia ie, normalising cholesterol and triglycerides.
Whereas, Dr Rabbani talked about the exacerbation of protein damage in diabetes and the development of vascular complications in diabetic patients.
Dr Paul at a symposium organised by a pharmaceutical, Merck Marker, addressed doctors and discussed latest research about the role of B-Vitamins in the prevention of diabetic complications like nephropathy, retinopathy and neuropathy. He focused on the role of Thiamine (Vitamin-B1) nutritional aspect and Thiamine deficiency in diabetes and how high doze Thiamine can prevent complications like dyslipidemia ie, normalising cholesterol and triglycerides.
He defined diabetic neuropathy as the presence of symptom and/or signs of peripheral nerve dysfunction in a patient with diabetes, for example numbness in hands and feet, tingling and burning sensations, gloves and stocking feeling etc.
The research has established that in the course of diabetes, some 20 percent -90 percent of individuals eventually develops neuropathies. The factor attributed to diabetes neuropathy can be grouped into those having a definite role for example poor glycaemic control meaning high blood sugar level and the duration of disease and those with a probable added influence for example hypertension, age, smoking, hyperinsulinaemia and dyslipidaemia meaning abnormal lipid profile.
Diabetic neuropathy requires medical attention because of its adverse effect on quality of life. Dr Rabbani in her talk said that the exacerbation of protein damage in diabetes and the development of vascular complications in diabetic patient and stressed the need for its management through proper diagnosis and medication.
The pharmaceutical organising this and many other similar symposiums to bring awareness to the people about health issues is performing its corporate social responsibility.
This company being a leader in neurotropic vitamins products and one of the leading promoter of diabetic care is of the view that academic sessions play a key role in the learning process of new and upcoming doctors as well as general practitioners.
However, the growing concern of the diabetics is the increasing cost of treatment and pathological examinations necessary to monitor the condition of a patient. All the medicines that a diabetics takes are classified as life saving drugs and those who are on medicines are required to follow the prescription throughout their lives.
Medicines are generally costly in Pakistan but drugs for the management of diabetes are costlier. At an average the patient needs minimum one thousand rupees per month to purchase medicines and about six hundred rupees to monitor blood sugar level.
The minimum a patient needs is Rs 18,000 per annum to manage his/her diabetes. Is diabetes management affordable in a country where per capita income is less than the needed money, more than 40 percent people live below poverty line and those who are in the middle income group and support a family of six members?